U.S.-funded HIV/AIDS, malaria initiatives represent 'new approach' to foreign aid, opinion piece says

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In her book "Dead Aid," author Dambisa Moyo comes to "disastrously wrongheaded conclusions" regarding U.S. foreign aid, columnist Michael Gerson writes in a Washington Post opinion piece.

He continues that although Moyo might be "on firm ground in criticizing decades of direct foreign assistance to African governments," she does not "take sufficient account" of newer, targeted international aid strategies, such as those advanced by U.S.-funded HIV/AIDS and malaria initiatives and the Millennium Challenge Corporation. Gerson writes that instead of allocating money directly to African governments, U.S. global health programs "required and achieved measurable outcomes and have often worked through civil society."

Gerson writes that Moyo "dismisses" the efforts of these initiatives by "stating that her book is 'not concerned with emergency and charity-based aid.'" However, U.S.-funded HIV/AIDS and malaria programs "are more than 'charity,'" and in fact "herald a new approach to foreign aid -- focused, centrally directed and results-oriented," Gerson writes. He continues that the President's Emergency Plan for AIDS Relief -- a program that Gerson advocated when he served in the White House under former President George W. Bush -- has provided HIV/AIDS treatment for more than two million people. In addition, the program's scale has "resulted in the strengthening of African supply, management and human resource systems -- encouraging a professionalism that bleeds through an entire health system and beyond," Gerson writes.

According to Gerson, Moyo in her book cited several inaccurate statistics regarding PEPFAR, and therefore "it is perhaps for the best that Moyo did not write on these issues." He continues that "it is not a minor thing for Moyo to dismiss and distort the achievements of a foreign aid program that helped save her homeland of Zambia from social and economic ruin." According to Gerson, about 7% of Zambians in need of antiretroviral drugs were receiving them in 2004; by September 2009, "that figure should exceed 66%." Although antiretrovirals "do not guarantee economic growth," Gerson writes that he expects "that a generation of hopeless mass death would have undermined Zambia's economic prospects."

According to Gerson, Moyo's "largest error is an overbroad condemnation of aid itself," when she contends that foreign assistance "fosters a military culture" and "engenders laziness on the part of African policy makers." Gerson writes, "Surely there is a difference between aid provided to oppressive kleptocrats and aid given to faith-based organizations distributing AIDS drugs." He continues that although it would be "noncontroversial" for Moyo to assert that some aid can be bad, it is "absurd" to conclude that all aid is bad. According to Gerson, Moyo's book chooses to "push the envelope of absurdity, proposing a 'world without aid' on a five-year timetable." He writes that although she "does not detail the possible outcomes" of suspending foreign aid, "we can reliably predict one of them." Gerson concludes, "Many now alive would be dead" (Gerson, Washington Post, 4/3).


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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